Should Your Child See a Doctor?
- Bleeding from 1 or both nostrils
- No known injury
- Nosebleeds are common because of the rich blood supply of the nose. Common causes include:
- Dryness of the nasal lining (e.g., from forced-air furnace in winter)
- Antihistamine (Reason: they also dry the nose)
- Vigorous nose blowing
- Ibuprofen and aspirin (Reason: increase bleeding tendency)
- Suctioning the nose can sometimes cause bleeding
- Picking or rubbing the nose
- Predisposing factors that make the nasal lining more fragile: nasal allergies, colds and sinus infections
When to Call Your Doctor for Nosebleed
Call 911 If…
- Your child has fainted or is too weak to stand
Call Your Doctor Now (night or day) If
- You think your child has a serious injury
- Bleeding does not stop after 10 minutes of direct pressure applied correctly and tried twice
- New skin bruises or bleeding gums not caused by an injury are also present
- Large amount of blood has been lost
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Age under 1 year old
- New-onset nosebleeds are occurring frequently
- Hard-to-stop nosebleeds are a recurrent chronic problem
- Easy bleeding present in other family members
Parent Care at Home If
- Mild nosebleed and you don't think your child needs to be seen
Home Care Advice for Nosebleed
- Nosebleeds are common.
- You should be able to stop the bleeding if you use the correct technique.
- Apply Pressure:
- Gently squeeze the soft parts of the lower nose against the center wall for 10 minutes. This should apply continuous pressure to the bleeding point.
- Use the thumb and and index finger in a pinching manner.
- If the bleeding continues, move your point of pressure.
- Have your child sit up and breathe through the mouth during this procedure.
- If rebleeds, use the same technique again.
- Insert Gauze:
- If pressure alone fails, insert a gauze wet with a few decongestant nose drops (e.g., nonprescription Afrin). (Reason: The gauze helps to apply pressure and nose drops shrink the blood vessels).
- If not available or less than one year old, use petroleum jelly applied to gauze.
- Repeat the process of gently squeezing the lower soft parts of the nose for 10 minutes.
- Prevent Recurrent Nosebleeds:
- If the air in your home is dry, use a humidifier to keep the nose from drying out.
- Apply petroleum jelly to the center wall of the nose twice a day to promote healing.
- For noseblowing, blow gently.
- For nose suctioning, don't put the suction tip very far inside. Also, move it gently.
- Avoid aspirin and ibuprofen (Reason: increase bleeding tendency).
- Expected Course: Over 99% of nosebleeds will stop following 10 minutes of direct pressure if you press on the right spot. After swallowing blood from a nosebleed, your child may vomit a little blood or pass a dark stool tomorrow.
- Call Your Doctor If:
- Unable to stop bleeding with 20 minutes of direct pressure
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
- Alvi A and Joyner-Triplett N. Acute epistaxis: How to spot the source and stop the flow. Postgrad Med. 1996;99:83-96.
- Guarisco JL and Graham III HD. Epistaxis in children: Causes, diagnosis and treatment. Ear Nose Throat J. 1989;68:522-538.
- McIntosh N, Mok J, Margerison A. Epidemiology of oronasal hemorrhage in the first 2 years of life: implications for child protection. Pediatrics. 2007;120 (5):1074-1078.
- Mulbury PE. Recurrent epistaxis. Pediatr Rev. 1991;12:213-216.
- Sharathkumar AA, Pipe SW. Bleeding disorders. Pediatr Rev. 2008;29 (4):121-129.
This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 8/1/2010
Last Revised: 9/18/2010 6:17:59 PM
Copyright 1994-2011 Barton D. Schmitt, M.D.